Environmental toxicants are increasingly linked to adverse birth outcomes such as low birth weight, preterm birth, birth defects and developmental delays. Inner-city populations are at high risk for adverse birth outcomes and also are more likely to be exposed to environmental toxicants. The Institute of Medicine and the National Environmental Education and Training Foundation recommend the integration of environmental health concepts into all levels of medical and nursing education. In the proposed SBIR project, Vida Health Communications, Inc. will produce, evaluate and distribute a multimedia package called "Managing Environmental Risks in Pregnancy". Drawing on the proven and specific advantages of DVD and web technologies, the media programs will teach about the health advantages of screening, assessing and mitigating potential exposure to known and suspected teratogens and environmental toxicants that pose a risk to the developing fetus. The package of educational visual media, web and print resources will consist of (1) training programs for prenatal health care providers who serve pregnant women who live in urban settings, (2) educational programs for pregnant women who live in urban settings, many of whom have low literacy and/or are of minority ethnicity, and (3) an electronic library of materials for providers to print and distribute to patients. In Phase I, the producers will develop both the patient education and clinical training curricula and produce prototypes of the media, which will then be evaluated using focus groups representative of the target audiences. Evaluators will use well-documented qualitative techniques to analyze focus group data. This project will advance the environmental health training of prenatal care providers serving women at risk for exposure to substances that can harm their developing fetus. It will also provide much needed education, at appropriate literacy levels, for at-risk women about ways that they can reduce fetal exposure to environmental hazards. Relevance to Public Health: We are just beginning to recognize the scope of teratogens that pregnant women may be exposed to living in urban environments. Given the rapid development of a fetus, especially in the early months of pregnancy, avoidance of exposure is at present the most effective way to mitigate potential harm. This research will contribute to knowledge of how prenatal care providers can interest, inform and motivate pregnant women who likely bear the greatest risk of exposure, so they can protect the fetus and improve the chance of giving birth to a healthy, normal infant. [unreadable] [unreadable] [unreadable]